Depression and mortality in nursing homes. J Am Med Assoc

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, United States
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 03/1991; 265(8):993-6. DOI: 10.1001/jama.265.8.993
Source: PubMed


To determine the prevalence rates of major depressive disorder and of depressive symptoms and their relationship to mortality in nursing homes, research psychiatrists examined 454 consecutive new admissions and followed them up longitudinally for 1 year. Major depressive disorder occurred in 12.6% and 18.1% had depressive symptoms; the majority of cases were unrecognized by nursing home physicians and were untreated. Major depressive disorder, but not depressive symptoms, was a risk factor for mortality over 1 year independent of selected physical health measures and increased the likelihood of death by 59%. Because depression is a prevalent and treatable condition associated with increased mortality, recognition and treatment in nursing homes is imperative.

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    • "Recognition rates of depression in older persons have typically been reported to be low [13] although more recent research indicates that the situation may be improving [14]. Recognition in this age group is particularly difficult because of the overlap of symptoms between depression and physical health problems [15,16] and between depression and dementia [17,18]). "
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    ABSTRACT: Background Those working with elderly care recipients require a good working knowledge of depression and appropriate help giving responses. While it is important for age-care staff to recognize depression in care recipients it is also critical that they know the appropriate course of action to assist a care recipient who may be depressed. This study aims to determine the knowledge of age-care staff of appropriate help giving responses, their confidence in knowing what kind of assistance to provide and their actual likelihood of providing help to potentially depressed care recipients and to examine if these measures improve following an intervention training program. Methods One hundred and two age-care staff were surveyed on their confidence in helping age-care recipients and on their knowledge of appropriate ways to provide assistance. Staff then participated in a two hour depression awareness raising intervention. The survey was repeated immediately following the training and again six months later. Results Staff confidence in knowing how to provide assistance increased significantly subsequent to training and remained significantly improved at the six month follow up. In addition, a significantly higher proportion of staff reported helping care recipients at the six month follow up. Conclusions This study highlights the potential of a brief staff training program to provide a cost effective means to improve staff self-confidence and increase the likelihood of staff providing assistance to depressed care recipients.
    BMC Nursing 04/2013; 12(1):10. DOI:10.1186/1472-6955-12-10
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    • "Major social change in a person's life has been linked to the onset of depression [1], with older people who are resident in care settings particularly at risk when initially moved from their home or another care setting. Depression in institutionalised adults increases the likelihood of death by 60% in the first year after onset [2]. Social contact is also seen as crucial to psychological well-being. "
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    ABSTRACT: Care settings for older people, such as nursing homes, can have low levels of social interaction, which has been shown in many studies as being crucial to both the mental and physical well-being of older adults. Furthermore, increased social interaction has been shown to have a positive effect on adjustment in institutions for the aged. However, these social connections can be lost due to movement within the care system, with residents regularly relocating for a variety of reasons including cost and medical issues. Eleven health professionals and six residents living in a care home in Ireland were interviewed about their social activities and levels of engagement within the home. Storyboards were then developed and presented to the residents based on these interviews. Findings from the interviews indicate that activity levels among the more cognitively able residents are quite low due to activities catering for the less able residents. Furthermore, a lack of access to information and resources (such as books and newspapers) means that these more able residents reported experiencing long periods of boredom. Technology can potentially allow residents access to such information and resources, enabling them to pursue activities in their personal time which can then also be used as the basis for group discussions. The use of technology could, in addition, allow those residents who had moved out of the home to continue to participate and collaborate in activities with the other residents.
    Computer-Based Medical Systems (CBMS), 2010 IEEE 23rd International Symposium on; 11/2010
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    • "In addition, findings suggest that increased depressive symptomatology was related to 12- month, all-cause mortality in this population, which is consistent with past research (Arfken, Lichtenberg, & Tancer, 1999; O'Connor & Vallerand, 1998; Rovner et al., 1991). When we included only participants who remained in the LTC facility or who were deceased, depressive symptoms remained a significant predictor, whereas cognitive functioning was not significant. "
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    ABSTRACT: This study investigated whether symptoms of depression and cognitive dysfunction predicted all-cause mortality in long-term care (LTC) residents at 12 months after admission. Participants were 171 adults with a mean age of 77 in an urban LTC setting (51% African American and 49% European American). The Geriatric Depression Scale and the Dementia Rating Scale, Second Edition (DRS-2), were administered upon admission, and demographic variables and the Charlson Comorbidity Index were also recorded. Cox regression analyses found that increased depressive symptoms, lower performance on the DRS-2, and European American ethnicity were significant predictors of all-cause mortality. The overall results suggest that the combination of cognitive dysfunction and depressive symptoms can increase the chances of 12-month, all-cause mortality in LTC settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
    Psychology and Aging 06/2010; 25(2):446-52. DOI:10.1037/a0019032 · 2.73 Impact Factor
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